title: Outcome of reintubated patients after scheduled extubation.
abstract: OBJECTIVE
  The main objective of study was to evaluate the outcome of patients who require reintubation after elective extubation.
  
  
  METHODS
  This is an observational, prospective cohort study including mechanically ventilated patients who passed successfully a spontaneous breathing trial. Patients were observed for 48 hours after extubation. During this time, reintubation or use of noninvasive positive pressure ventilation was considered as a failure. Reintubated patients were followed after the reintubation to register complications and outcome.
  
  
  RESULTS
  A total of 1,152 extubated patients were included in the analysis. Three hundred thirty-six patients (29%) met the criteria for extubation failure. Extubation failure was independently associated with mortality (odds ratio, 3.29; 95% confidence interval, 2.19-4.93). One hundred eighty patients (16% of overall cohort) required reintubation within 48 hours after extubation. Median time from extubation to reintubation was 13 hours (interquartile range, 6-24 hours). Reintubation was independently associated with mortality (odds ratio, 5.18; 95% confidence interval, 3.38-7.94; P < .001). Higher mortality of reintubated patients was due to the development of complications after the reintubation.
  
  
  CONCLUSIONS
  In a large cohort of scheduled extubated patients, one third of patients developed extubation failure, of whom half needed reintubation. Reintubation was associated with increased mortality due to the development of new complications after reintubation.
authors.affiliation: Hospital Universitario de Getafe and CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Frutos-Vivar
authors.affiliation: Hospital Universitario de Getafe and CIBER Enfermedades Respiratorias, Madrid, Spain. Electronic address: aesteban@ucigetafe.com.
authors.forename: Andrés
authors.initials: A
authors.lastname: Esteban
authors.affiliation: Hospital Profesor A.Posadas, Buenos Aires, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Apezteguia
authors.affiliation: Clinica Medellín and Universidad Pontificia Bolivariana, Medellín, Colombia.
authors.forename: Marco
authors.initials: M
authors.lastname: González
authors.affiliation: King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Yaseen
authors.initials: Y
authors.lastname: Arabi
authors.affiliation: South Texas Veterans Health Care System Audie L. Murphy Division and University of Texas Health Science Center, San Antonio, TX.
authors.forename: Marcos I
authors.initials: MI
authors.lastname: Restrepo
authors.affiliation: Hospital del Henares, Madrid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gordo
authors.affiliation: Hospital de Clínicas de Montevideo, Uruguay.
authors.forename: Cristina
authors.initials: C
authors.lastname: Santos
authors.affiliation: King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Jamal A
authors.initials: JA
authors.lastname: Alhashemi
authors.affiliation: Hospital de Clínicas de Caracas, Venezuela.
authors.forename: Fernando
authors.initials: F
authors.lastname: Pérez
authors.affiliation: Hospital Universitario de Getafe and CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Peñuelas
authors.affiliation: South Texas Veterans Health Care System Audie L. Murphy Division and University of Texas Health Science Center, San Antonio, TX.
authors.forename: Antonio
authors.initials: A
authors.lastname: Anzueto
mesh_terms: D000368:Aged; D060666:Airway Extubation; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D017211:Treatment Failure; D016896:Treatment Outcome; D015300:Ventilator Weaning